Evidence on the association between mental health disorders and cancer risk is inconclusive, despite well-established associations between mental health disorders and lifestyle factors such as ...smoking. This study examines the relationships between depression, anxiety and cancer risk, and the potential mediating effects of lifestyle factors.
A study of 34,571 participants aged 40-69 years in the CARTaGENE cohort was conducted. Depression was defined by questionnaire (PHQ-9), antidepressant use, and a composite of questionnaire, antidepressant use, or lifetime self-reported physician diagnosis. Anxiety was defined by questionnaire (GAD-7). Co-morbid depression and anxiety was also assessed. Cox regression models were used to investigate associations between mental health and risk of prostate, lung, and all cancers combined. Mediating effects of lifestyle factors were assessed using Baron and Kenny mediation criteria.
There were positive associations between mental health disorders, all cancers and lung cancer risk, however with the exception of anxiety and lung cancer in women (Hazard Ratio HR = 1.67, 95% CI: 1.01-2.76), associations were attenuated with adjustment for sociodemographics, health status and lifestyle factors. In the mediation analysis, smoking accounted for 27%, 18%, and 26%, of the total effect between depression (PHQ-9), anxiety, and co-morbidity and lung cancer, respectively in women. In men, smoking accounted for 17% of the total effect between depression (PHQ-9, antidepressant, or lifetime self-report of physician diagnosis) and all cancers.
Positive associations were observed between mental health disorders, all cancer and lung cancer risk, however most relationships were attenuated with adjustment for lifestyle factors. Smoking status mediated a significant proportion of the relationships between mental health disorders and cancer risk.
Certain population sub-groups in the United States are vulnerable to micronutrient malnutrition. Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) ...describing the biochemical status of vitamins A, B6, B12, C, D, E, folate, and anemia, were aggregated to determine the overall risk of multiple concurrent deficiencies in U.S. children and adults (
= 15,030) aged >9 years. The prevalence of deficiency risk according to socio-demographic, life-stage, dietary supplement use, and dietary adequacy categories was investigated. Thirty-one percent of the U.S. population was at risk of at least one vitamin deficiency or anemia, with 23%, 6.3%, and 1.7% of the U.S. population at risk of deficiency in 1, 2, or 3-5 vitamins or anemia, respectively. A significantly higher deficiency risk was seen in women (37%), non-Hispanic blacks (55%), individuals from low income households (40%), or without a high school diploma (42%), and underweight (42%) or obese individuals (39%). A deficiency risk was most common in women 19-50 years (41%), and pregnant or breastfeeding women (47%). Dietary supplement non-users had the highest risk of any deficiency (40%), compared to users of full-spectrum multivitamin-multimineral supplements (14%) and other dietary supplement users (28%). Individuals consuming an adequate diet based on the Estimated Average Requirement had a lower risk of any deficiency (16%) than those with an inadequate diet (57%). Nearly one-third of the U.S. population is at risk of deficiency in at least one vitamin, or has anemia.
The relationship between diet and cancer is often viewed with skepticism by the public and health professionals, despite a considerable body of evidence and general consistency in recommendations ...over the past decades. A systems biology approach which integrates 'omics' data including metabolomics, genetics, metagenomics, transcriptomics and proteomics holds promise for developing a better understanding of how diet affects cancer and for improving the assessment of diet through biomarker discovery thereby renewing confidence in diet-cancer links. This review discusses the application of multi-omics approaches to studies of diet and cancer. Considerations and challenges that need to be addressed to facilitate the investigation of diet-cancer relationships with multi-omic approaches are also discussed.
Predominantly plant-based diets can co-benefit human physical health and the planet. Young adults appear to be on the forefront of the shift to plant-based diets. However, little is known about the ...relationship between plant-based diets and mental health in this population even though mental health disorders contribute substantially to the global burden of disease, particularly among this age group. In this cross-sectional study we utilize a biopsychosocial framework to assess the association between dietary intake and mental health and wellbeing. Mental health was assessed using self-reported measures of anxiety (GAD-7), depression (PHQ-9) and quality of life (single-item). Dietary intake in the prior month was assessed using a dietary screener (DSQ) and participants were asked to self-identify a diet preference (e.g., vegan). 339 university undergraduate students. A principal component analysis of dietary intake found three dominant dietary patterns (plant-based, animal-based, and 'junk foods'); 28.1% (n = 95) of participants self-identified as pescatarian, vegetarian, vegan, other. The association between dietary patterns, diet preference and mental health was assessed through regression analysis. After controlling for covariables, we found a significant positive association between the junk food component and depression (z-score beta = .21, pless than or equal to.001; adj. R.sup.2 = .39) and anxiety (z-score beta = .14; pless than or equal to.001; adj. R.sup.2 = .32) while no association was found between plant-based, animal-based or self-identified diet preference and the mental health measures. We did not find a negative association between predominantly plant-based diet patterns and mental health and wellbeing. It is important to consider dietary composition and to conceptualize diet as a health behaviour that is embedded in a biopsychosocial framework.
We examined total activity, light activity, and moderate-to-vigorous physical activity (MVPA) as predictors of mortality in a nationally representative sample of older adults. Then we explored the ...theoretical consequences of replacing sedentary time with the same duration of light activity or MVPA.
Using accelerometer-measured activity, the associations between total activity, light activity (100-2019 counts per minute), and MVPA (>2019 counts per minute) counts and mortality were examined in adults age 50 to 79 yr in the National Health and Nutrition Examination Survey, 2003-2006 (n = 3029), with mortality follow-up through December 2011. Cox proportional hazard models were fitted to estimate mortality risks. An isotemporal substitution model was used to examine the theoretical consequences of replacing sedentary time with light activity or MVPA on mortality.
After adjusting for potential confounders, including age, sex, race/ethnicity, education, BMI, and the presence of comorbid conditions, those in the highest tertile of total activity counts had one fifth the risk of death of those in the lowest tertile (hazard ratio HR = 0.21, 95% confidence interval CI = 0.12-0.38), and those in the middle tertile had one third the risk of death (HR = 0.36, 95% CI = 0.30-0.44). In addition, replacing 30 min of sedentary time with light activity was associated with significant reduction in mortality risk (after 5 yr of follow-up: HR = 0.80, 95% CI = 0.75-0.85). Replacing 30 min of sedentary time with MVPA was also associated with reduction in mortality risk (HR = 0.49, 95% CI = 0.25-0.97).
Greater total activity is associated with lower all-cause mortality risk. Replacing sedentary time with light activity or MVPA may reduce mortality risk for older adults.
This essay draws on an original cross-sectional survey of 1,010 children and their guardians in highly migratory regions of Anhui and Jiangxi provinces located in China's interior. It uses propensity ...score matching, a technique that mitigates endogenity, to examine the impact of parental migration and post-migration guardianship arrangements on the children's educational performance as measured by test scores for Chinese and mathematics. One core finding is that the educational performance of children is adversely affected by parental migration only when both parents migrate or when a non-parent guardian is the principal carer. Additionally, longer durations of parental absence are associated with poorer educational performance. The migration of two parents only significantly adversely affects the educational performance of boys. There is no significant effect on the educational performance of girls. On the basis of our findings we argue that rather than support left-behind children within the countryside, the long-term policy response should be to remove the institutional obstacles that prevent family resettlement in the cities.
An estimated 33%-40% of patients in Canada report financial distress following a cancer diagnosis, including worrying about mortgage payments, depleting their savings, and returning to work before ...being physically ready. Financial toxicity, which refers to the direct, indirect and emotional costs to patients following a cancer diagnosis, is increasingly recognized as a risk factor for poor health and cancer outcomes. Here, Wood and Murphy discuss how financial toxicity can manifest for patients with cancer in Canada and how to address it. Although Canada's health care systems offer free primary and hospital care to residents, people with cancer often face substantial costs that must be paid out of pocket, including those for cancer drugs and treatments, at-home medical equipment, home care, and nutritional supplements. Unlike drugs and services provided in hospital, at-home health services and take-home prescription drugs are not required to be publicly funded under the Canada Health Act. The proposal for the Canada Pharmacare Act frequently references the cost of cancer drugs as an example of the burden of drug costs for people in Canada and the need for more comprehensive, national drug funding.
Emerging evidence suggests muscle depletion predicts survival of patients with cancer.
At a cancer center in Alberta, Canada, consecutive patients with cancer (lung or GI; N = 1,473) were assessed at ...presentation for weight loss history, lumbar skeletal muscle index, and mean muscle attenuation (Hounsfield units) by computed tomography (CT). Univariate and multivariate analyses were conducted. Concordance (c) statistics were used to test predictive accuracy of survival models.
Body mass index (BMI) distribution was 17% obese, 35% overweight, 36% normal weight, and 12% underweight. Patients in all BMI categories varied widely in weight loss, muscle index, and muscle attenuation. Thresholds defining associations between these three variables and survival were determined using optimal stratification. High weight loss, low muscle index, and low muscle attenuation were independently prognostic of survival. A survival model containing conventional covariates (cancer diagnosis, stage, age, performance status) gave a c statistic of 0.73 (95% CI, 0.67 to 0.79), whereas a model ignoring conventional variables and including only BMI, weight loss, muscle index, and muscle attenuation gave a c statistic of 0.92 (95% CI, 0.88 to 0.95; P < .001). Patients who possessed all three of these poor prognostic variables survived 8.4 months (95% CI, 6.5 to 10.3), regardless of whether they presented as obese, overweight, normal weight, or underweight, in contrast to patients who had none of these features, who survived 28.4 months (95% CI, 24.2 to 32.6; P < .001).
CT images reveal otherwise occult muscle depletion. Patients with cancer who are cachexic by the conventional criterion (involuntary weight loss) and by two additional criteria (muscle depletion and low muscle attenuation) share a poor prognosis, regardless of overall body weight.
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